Ninety percent of oncologists say they have sometimes not had the cancer drugs they need for their patients, a new survey says.

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FRIDAY, May 25, 2012 — More than 90 percent of 200 oncologists surveyed say they have had experienced shortages of key cancer drugs needed by their patients.

Patients with some of the most common cancers — including breast, prostate, and lung as well as various leukemias and lymphomas — are affected, according to MDLinx, a news source for medical professionals that conducted the poll.

Doxorubicin, a medication used to treat a number of different cancers and sold under the brand names Adriamycin and Rubex, was the drug most oncologists said was unavailable. Following that were cytarabine (Cytosar-U and Tarabine) — used on its own or with other chemotherapy drugs to treat certain types of leukemia — and methotrexate, which is used to treat autoimmune diseases as well as various types of cancer

"We have all read about the manufacturing challenges behind the shortages, but I was shocked to find that nearly all our physicians have experienced shortage issues," said Stephen Smith, chief marketing officer for MDLinx. "That represents a lot of cancer patients."

"We should be better than this," wrote Dr. J. Leonard Lictenfeld, deputy chief medical officer for the national office of the American Cancer Society in a blog post about drug shortages on the society's Web site. "We need efficient and effective exchange of information. We need a plan to accelerate production of drugs in imminent and existing shortage. We need the quality problems addressed as rapidly as possible." One in 10 oncologists reported that their patients were tapping into the "gray market" to find cancer meds.

Illicit or Questionable Sales of Cancer Drugs

The gray market is trade in counterfeit or illegally obtained or imported drugs not approved by FDA. At times, gray market sellers stockpile medications to sell at marked-up prices to desperate pharmacists. Other times, when there are shortages of certain approved drugs, they buy up foreign drugs not approved for use in the United States.

Counterfeit versions of the intravenous cancer drug Avastin, apparently shipped from the Middle East, have been found in clinics in California, Illinois, and Texas, the New York Times reported in April.

The MDLinx survey also revealed that 42 percent of oncologists were concerned about the safety of even those drugs from overseas that have been approved by FDA.

"Some drugs have to be refrigerated," pointed out one oncologist participating in the survey. "I worry about the efficacy of the drug when it has been shipped such long distances." Many drugs are manufactured in countries such as China and India.

What's Causes Shortages?

Many cancer drugs have been used for years and have gone off-patent, meaning companies can make generic versions as long as they are approved by the FDA.

Over time, however, the number of generic manufacturers has dwindled, explained Dr. Lictenfeld in his blog post. Sometimes, just two or three companies are manufacturing some drugs. When one company has a problem supplying a medication, because of problems ranging from quality control at their plants to shortages of raw materials, there can be huge repercussions for doctors and patients.

Unfortunately, there is no tracking system in place that requires manufacturers to notify the public or other drug companies when they a certain drug is in short supply. As a result, when one company falls short, other companies that make the drug may not be aware of the problem and therefore don't ramp up production.

A few private and non-profit companies have stepped up to provide versions of a tracking service, but their databases are often incomplete.

In his blog, Lictenfeld urged medical professionals and government officials to focus their attention on this issue.

"Our children deserve the best care we can offer, as do all of our patients facing cancer treatment," he said in his post. "The disease itself is tough enough to deal with. Whether or not the drug you need to save your life is available should not add to that burden."

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